Transcript Document

PSI & VCT:
Social Marketing Approaches
to Voluntary Counseling
and Testing
Hang Trinh, MD, MPH
Senior Program Manager
PSI/Vietnam - August 2005
Strategic Objectives of PSI Vietnam
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Increase knowledge of and demand
for VCT services by select target
groups
Increased capacity of partners to
implement social marketing
interventions
Addressing issues related to
decreased stigma of HIV-positive
persons and the use of VCT services
in high-prevalence communities
Target populations
 Injecting
Drug Users
 Sex Workers (Direct (street based)
and Indirect (karaoke, massage)
 Sexual partners of most at risk
populations
 Short, Most at Risk Populations
(MARP)
Increased knowledge of and
demand for VCT

Simply: Get more vulnerable groups to
access VCT services
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HOW? Development of an integrated
marketing and communications
campaign
A Social Marketing Strategy
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Formative Research
– Identify the barriers of MARPs to accessing
VCT
– Develop messages to break down those
barriers
Segmentation and focused targeting
 Develop the marketing strategy
 Develop the communications campaign
 Monitoring and evaluation

SUMMARY OF PSI/VN’S
QUALITATIVE RESEARCH
ON VCT
What we wanted to know
 How
do MARP perceive VCT:
 Understand
motivational triggers, perceived
barriers and benefits to accessing VCT
 Users‘
of VCT past experiences:
 Obtain
insight into the benefits and
advantages of knowing HIV status
Why?
 To
develop a focused
communications campaign to
increase informed demand for VCT
 Simply
put, convince vulnerable
populations to access VCT
Methodology
14 In-depth interviews w/prior users of
VCT
 16 Focus Group Discussions w/target
group (generally non users):
 Study Groups
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 IDUs
 SWs (Direct and Indirect)
 Sexual Partners of IDUs
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Target Sites: Hanoi and Hai Phong
Many misconceptions of VCT
dominate, especially w/SWs:
 Few
non-users know where VCT
sites are located
 Knowledge of services is vague,
and VCT is not well differentiated
from hospital testing
 Past negative experiences with
health care system shape feelings
about VCT
Barriers to Access
(Linked to Stigma and Fear)
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Stigma/discrimination against PLWHA, as well as
behavioral related stigma (IDU and SW)
“I’m sure that 100 drug addicts all have the same
thought. They’re afraid of being isolated, kept away,
and losing the chance to go back to their family.”
(Hanoi IDU)
 Being recognized by friends or acquaintances
 Issues related to Confidentiality
 Fear of positive result, and with no cure for HIV/AIDS,
there is no reason to get tested—hopeless and
depression that would accompany.
Barriers to Access
(More surprising)
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Among sex workers the fear that testing
will result in loss of income
“We accept the fact that we might contract the
disease, however we don’t dare to go for a medical
examination because people might start rumors
about our problem and keep away from us.
Consequently, we will find it difficult to continue our
jobs, to earn money, to feed our children. This is a
reality”. (Hai Phong street-based sex worker)
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Fear of being treated badly by health
workers
Motivational triggers for
accessing VCT
A family member, friend demonstrating
symptoms of AIDS
 Outreach workers can be crucial

“Now there is a peer group. They came to my house and
invited us to join the group activities. We joined for one
meeting and last Sunday went for the 2nd time. Then I
noticed my husband got sick, so my husband and I
planned to go [for VCT].” (Hanoi partner of IDU)
Motivational triggers for
accessing VCT
A close call
 To make a ‘New Start’ (relationship,
getting clean)
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“There is a girl who loves me. I will go for the test
in order to protect her. I really love her and will
make a new start if I’m not infected.” (Hanoi IDU)
Perceived Benefits of
accessing VCT
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Opportunity to protect partners and
family members from infection
“The test result is positive. I use drugs and I have to
accept that. I’m okay, but knowing that I am positive, I’m
thinking of my wife. She is my hope.”
(Hai Phong
IDU)
Perceived Benefits of accessing VCT
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Peace of mind and relief from anxiety and
worry:
 Relief is the converse of the fear of
hopelessness if found positive.
Opportunity to protect oneself from
becoming infected (especially for CSWs)
 A chance to start again with a brighter
future.
 Access to medical care
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Key Desired Characteristics of VCT
services: What do people want?
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Confidential and Anonymous Testing.
Friendly, sympathetic, and respectful staff
Staff they don’t already know
Convenient (times & locations)
Counseling with accurate information to prevent
transmission.
Accurate test results
Free or low cost service
Quick results with short waiting time
Routine testing or making it "normal" was proposed as
a way to ameliorate the anxiety surrounding testing. If
everybody does it, it won’t be so embarrassing or
frightening.
Started off in Beginning with a Real
Social Marketing Challenge
Creating demand for a service:
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With high latent need
(but very low perceived need)
With possibilities of being highly stigmatized
Capable of making frightening revelations
Whose benefits are neither tangible nor clear
That initially promised no curative or medical back
up . . And the preventive benefits were not really
widely understood
Media Messages: Phase 1 (2005)
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Increased general awareness of VCT as a
new service available in Vietnam through
promotion of specific VCT centers. The
goal is for populations to:
 be well aware of what VCT is;
 and that promoted services are a quality and highly
confidential service;
 know exactly where such services are located in their
community;
 feel confident that they will be welcomed at these
VCT sites;
Media Messages: Phase I (2005)
Provide Correct Site Information
 Locations
 Clarification of Services offered
 Operating hours
Media Messages: Phase I (2005)
Define Quality of Service
 Confidentiality
 Friendly, sympathetic staff attitude
 Accurate, timely results
Media Messages: Phase I (2005)
Emphasizing Counseling and Talking
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Calm anxieties
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Opportunity to “Work out problems”
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“Protect yourself and your family”
Sample of Concept Design
Media Messages: Phase II (2006)
Emphasize benefits of knowing serostatus
 Building personal conviction in the
perceived benefits of learning one’s status
via VCT, including:
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 to protect loved ones from possible infection;
 to plan for a brighter future- including marriage or
children, new work;
 if you are negative, learn ways of staying negative;
 peace of mind and relief from worry;
 if you are positive – access to medical care;
Signage
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Signs should:
 avoid using “HIV” or “AIDS”
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Branding Sites will increase awareness
and acceptability of sites, and serve to
link advertising campaigns with sites
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Promotional materials should:
 Clearly identify sites as VCT clinics
 Give detailed directions and hours
Brand Name & Logo
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Brand name: Implying a new
beginning in life
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Logo: Depicting “Hope” through
rising sun and vibrant colors
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Product description:
“Counseling and Testing Centre”
(Not “HIV/AIDS center”)
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Includes desired action right
in slogan itself:
“A New Horizon!”
Long Term (and not easy)
Lowering Stigma is essential
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Use role models to break the silence
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Make testing a part of normal life
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Behavioral stigmatization needs to be
addressed
Conclusions
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Social marketing can be successfully used to
increase demand for VCT services
Research is key to prioritizing messaging
Two phases will be utilized, emphasizing
– Knowledge of VCT, service attributes, and
locations
– Benefits of accessing VCT
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Stigma against PLWHA and discrimination of
specific groups (IDU/SW) is very high and
should be addressed concurrently with VCT
promotion activities for maximum benefit